Tuesday, March 17, 2009

I was reading a blog post today from Diabetics Daily and while this issue doesn’t pop up on our blog too often, it's apparently a concern on other diabetes related blogs and message boards.

From Diabetics Daily, Sara Knicks writes:I just got back from a recent work trip that involved some airlines flights. I have noticed (especially on the message boards) that a lot of diabetics worry about being stopped and forced to endure extra inspections because of their diabetic supplies.

As a Type II Diabetic, I can definitely see why people would be concerned about this.

First and foremost, if you’re concerned about your disability in relation to the screening process, let a Transportation Security Officer (TSO) know what’s going on and what you’re concerned about. Of course, you don’t have to do this, but as a former TSO, I can tell you that the screening of people with disabilities goes much more smoothly if everybody involved knows what to expect.

Also, don't go lettin' the checkpoint get you all hypogleycemic. Be sure to let a TSO know if your sugar is dropping or if you need medical assistance. Tell them what you need.

If you’re concerned about any of your diabetes related items, let the TSO know what you’re traveling with. The following items are permitted for diabetic passengers:

Insulin pump and insulin pump supplies (cleaning agents, batteries, plastic tubing, infusion kit, catheter, and needle); Insulin pumps and supplies must be accompanied by insulin. If you are concerned or uncomfortable about going through the walk-through metal detector or Mill with your insulin pump, notify the TSO that you are wearing an insulin pump and would like a full-body pat-down and a visual inspection of your pump instead. Advise the Security Officer that the insulin pump cannot be removed because it is inserted with a catheter (needle) under the skin.

Insulin and insulin loaded dispensing products (vials or box of individual vials, jet injectors, biojectors, epipens, infusers, and preloaded syringes; Insulin in any form or dispenser must be clearly identified.

Unlimited number of used syringes when transported in Sharps disposal container or other similar hard-surface container. Sharps disposal containers or similar hard-surface disposal container for storing used syringes and test strips.

You have the option of requesting a visual inspection of your insulin and diabetes associated supplies.

Be sure to check out another blog post titled “Diabetes and the TSA.” A passenger named “James” writes about his experiences traveling with his insulin pump. You can also read more about traveling with other disabilities at TSA.gov.

RB, Byetta hasn't needed to be kept cool for a couple of years now. See the Byetta site's FAQ on safety and storage:"How do I store my BYETTA Pen when I am traveling?After first use, your BYETTA Pen can be kept at a room temperature not to exceed 77°F (25°C). Do not freeze. Do not use BYETTA if it has been frozen. BYETTA should be protected from light."

My doctor wants to put me on an insulin pump. I've resisted because of my previous rotten experiences with the TSA. If this pst does indeed state official TSA policy, and there's some way to keep individual TSOs from arbitrarily and capriciously overriding it, then I'll reconsider. The latter is important: I've *never* had a supervisor, or a checkpoint manager, *ever* overrule an individual TSO when they've violated official TSA policy.

Ann Said:"How could we get the TSA to add continuous glucose monitors to the list? Personally I have had a problem with this as a traveler, but it would be great if it were officially written down."

An interesting question Ann, and to be honest I had to go to WebMD to find out what a CGMS is.

WebMD says that the device is pager sized and is worn on the hip or belt. It also says that the device is not designed for day-to-day continuous monitoring. Additionally, the device uses a plug in wire to attach to the probe and that it can be removed as the system does not monitor continuously but at intervals of between 5 minutes and an hour. I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem.

Bob @"Of course, you don’t have to do this, but as a former TSO, I can tell you that the screening of people with disabilities goes much more smoothly if everybody involved knows what to expect."

How much of your medical information do you have to share with the TSA?

Does this blog advice only work for diabetics, or are people with more unusual conditions or devices required to share more detailed medical information with the TSO?

My STL TSO supervisor said I could have kept my gel-pack for medicine, just not infants. He must have missed the web-memo that said breast milk is in the same category as medicine, even though the special needs page includes "Liquids including water, juice, or liquid nutrition or gels for passengers with a disability or medical condition".

How much do you have to do to prove a "disability or medical condition" to TSA?

TSORon said... Ann Said:"How could we get the TSA to add continuous glucose monitors to the list? Personally I have had a problem with this as a traveler, but it would be great if it were officially written down."

An interesting question Ann, and to be honest I had to go to WebMD to find out what a CGMS is...........................

Continuous monitoring is a godsend for those who are hypoglycemic unaware Ron. It can be a real lifesaver!

In recent years effort has been expended on better glucose monitors including CGMS units intended for full time use. Technology is not quiet there yet but expect to see more of this units as time passes.

If a traveler has on of these units in use they also have a sensor that is inserted under the skin.

TSARon said (refering to CGMS): "WebMD says that the device is pager sized and is worn on the hip or belt. It also says that the device is not designed for day-to-day continuous monitoring. Additionally, the device uses a plug in wire to attach to the probe and that it can be removed as the system does not monitor continuously but at intervals of between 5 minutes and an hour. I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem."

Ron, you obviously know nothing about CGMSs. The glucose monitor is much smaller than a pager and is implanted over the skin and cannot be removed (unless you don't want to use it anymore and are exchanging it for a new one). Since you are a TSO, your lack of knowledge and belief that it is OK to ask to remove it is unacceptable.

I have had no end of trouble with insulin pumps. You may say those are your rules all you like. In practice, your people have no idea what they are, and don't know what to do about them. The best solution for me is to disconnect before going to the checkpoint. Saves me a lot of headache, although I really should not have to do that.

BTW - insulin is a very good way to kill a person. It is, effectively, a weapon, and a weapon you cannot keep off airplanes unless you want to limit airspace to non-diabetics. Get over trying to keep weapons that can hurt only individuals. They are only a threat to individuals, not to aviation.

TSORon, your highly technical web search gave you a completely wrong idea of what continuous glucose monitoring is. Worse, you are now using it to come to your own little conclusion that "removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem". You are so wrong I can't even begin to explain it to you.

Meanwhile, I am STILL waiting to know what the policy is for screening small children in airports using MMW as primary. Are they, or are they not, patted down??

Now that this has been officially announced on the blog that the information will be immediately read by/to every TSO at the regular "shift briefs"? Or will it be carefully round-filed by the middle-managers?

I'm sure my mother, who has been a insulin-dependent diabetic for 30 years, would appreciate it if the original post was propagated to every TSO checkpoint as required reading.

Oh, and asking a diabetic to "dose" themselves to prove an insulin pump works is pretty poor form.

I am the author of the original post. It sounds like a lot of these comments are in regard to hypothetical worries. I didn't write about it in my original post that this article links to, but I have never had concern over the ice/gel packs that my insulin is packed with, the syringes (new and used), or any of my other diabetic supplies. We are truly much more common than we think. I have to remind myself that I am not the first diabetic a TSA screener (and especially their manager) has seen.

There is also an interesting thread about diabetes and air travel within the Diabetes Daily forum.

Are you practicing medicine without a license again? Because your statements here are to that effect. That and the show really how much you don't know and that lack of knowledge is to the determent of the traveling public that rely on certain devices and medications to STAY ALIVE. It also brings out the point that all of the rules need to be published and that all DHS/TSA employess know what they are, and maybe even tested on a regular basis to ensure the rules aren't made up on the fly that happens with a high frequency currently (SFO and OMA in the past couple of days are a good example of this)

If you think high or low blood sugar isn't dangerous I ask that you go to the nearest county hospital or talk with EMS professionals in the field about the subject as what they have experienced and know might shock you.

Uneven application of secret rules that cannot be challenged as you noted is a serious problem. Even here on this blog when a TSO mis-states known rules they are not corrected. Remember TSO NY?

On a side note, those who pump report greatly improved control and say life is much better.

I would probably go with the pump and if a TSO did something to cause me harm I would take ever legal action against them personally that I could.

Malpractice is not limited to doctors!

My fellow Americans,

Please, please, please understand that ANY screener cannot legally ask you any questions concerning your illness or treatment. That's a felony violation of HIPPA. Any screener cannot decide what medicines you can or cannot take on your flight, including breast milk. That's a felony called "practicing medicine without a license."

If this happens to you at any checkpoint in what's left of the United States of America, politely ask the screener where they got their medical degree. Politely remind them that practicing medicine without a license is a felony. If they don't back down, call over a cop and require that the screener and, if appropriate, their supervisor, be arrested for practicing medicine without a license.

We, the People, need to make an example of a few screeners, prosecute them to the fullest extent of the law, and send them to jail for a VERY long time.

I have type II diabetis, however I am on medication only (Amaryl and Actos) and do not require direct injection of insulin. Will I be still allowed to keep my blood glucose meter kit (lancets, blood glucose meter, test strips, alcohol swabs, and glucose tablets) on person ?

This thread is a perfect illustration of why secret rules constitute an actual threat to the safety of passengers rather than an enhancement to security.

As things now stand any rogue TSO can totally disregard the TSA policy Blogger Bob covered in the original post (if it really is TSA policy; we can't tell for sure since it it SSI!) and the passenger has absolutely no recourse.

A simple request to "show me the written rules" is more likely to result in a civil fine than an actual peek at any written rules.

I can think of no better example of an agency run amok than one which puts people at risk to their life in order to "protect" them. Sounds sort of like, "In order to save the village, we had to destroy it."

I'm glad to see an official blog post on this issue. I'm not diabetic, but I do need weekly injections of a very expensive "biological" medication that has to be kept refrigerated or cooled with gel packs. I am very much afraid of encountering a situation like that of our Mr. Gel-Pack.

For me, the consequences of improper TSO action would be far more severe than what the Gel-Pack family suffered. Mrs. Gel-Pack at least has ready access to a redundant set of portable manufacturing facilities that can replace what the TSO improperly confiscated. But should a TSO improperly confiscate my gel packs or open the sterile package my injections come in (which an inept TSO apparently once did to someone carrying a feeding tube), I'd either have to suffer the consequences of doing without the medication or pay thousands of dollars to replace it (which would not be covered by insurance).

I realize that if I did travel with my medication in a cooler with gel packs, the TSO would most likely handle it professionally and courteously, and I'd be on my way with only the minimum hassle necessary to ensure the safety of aviation. But based on two experiences with TSOs improperly confiscating items of far less importance, I consider the risk of encountering an incompetent or poorly trained TSO who acts improperly is just too much to tolerate. The risk is probably small, but the cost to me is unacceptably high if it were to happen. (It's the same assumption that drives the TSA: the risk of terrorist attacks is vanishingly small, but the effect is so devastating if it does happen that it justifies subjecting every passenger to "layers" of arbitrary hassles.) So my only practical option is to limit my trips that require air travel to a week or less, so I can avoid this problem entirely.

Yes, I'm well aware that carrying my medication in a cooler with gel packs is specifically permitted under published guidelines, and that TSOs are supposed to follow procedures to inspect it safely. But I'm just as aware that TSOs don't always do what they're supposed to, and that the rules in effect at checkpoints as implemented by TSOs aren't always consistent with what's officially published. I'm also aware that I have absolutely no effective recourse if that happens. The TSO is always right, the passenger is always at fault, and I'll have to comply with whatever the TSO decides the rules are at that moment if I want to fly today. And the fact that I have commented on this concern here once before and been completely ignored doesn't help.

The real irony is that my astronomically-priced medication gives me a nearly-normal life and allows me to travel. But my justified fear of what an inept or poorly-trained TSA officer might do if I try to carry my medication through a checkpoint is what ends up limiting my travel. The fact that this fear and risk is completely unnecessary, and that there's nothing I can really do about it, makes me very angry. It exemplifies the way the arrogant and unaccountable TSA gives citizens reason to fear their own government more than the terrorists from whom they are supposedly protecting us. That's the real tragedy of 9/11.

"It sounds like a lot of these comments are in regard to hypothetical worries."

These are legitimate concerns prompted by TSA's own bad behavior in similar situations in the past.

"I didn't write about it in my original post that this article links to, but I have never had concern over the ice/gel packs that my insulin is packed with, the syringes (new and used), or any of my other diabetic supplies."

That's very nice for you. However, Mr. Gel-pack and other cases clearly demonstrate that every citizen is at risk of rogue TSA employees deciding to make up rules on the spot, no matter the cost in life or health nor the official, stated policies of the TSA.

I openly admitted that I know nothing about CGMS's, I even had to look up what they are, and it seems that I am the only one that took the time to do that. I think I'll stick with the information I have from a reputable source like WebMD and not from the personal opinions I find here.

But here is what I know from the policies the TSA uses. If an individual says it’s a medical device, it should pass through without further comment. If it cannot be removed and causes an alarm on the WTMD, the passenger must undergo a pat-down to clear the alarm. If the alarm cannot be resolved then the passenger must make a choice, remove the device or find another way to travel. I know, not the answer that anyone here is going to like, but facts are facts. I don’t make the policies, I just enforce them.

“WebMD says that the device is pager sized and is worn on the hip or belt. It also says that the device is not designed for day-to-day continuous monitoring. Additionally, the device uses a plug in wire to attach to the probe and that it can be removed as the system does not monitor continuously but at intervals of between 5 minutes and an hour. I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem.”

Just in case you haven’t been castigated enough, Ron –

Medical decisions are made by medical practitioners in consultation with their patients. Advising a “pax” that it wouldn’t be a problem to remove any medical device for the brief period of screening is, legally, the provision of medical advice. It isn’t up to you to provide medical advice about what is or isn’t a problem with regard to any medical device. It’s particularly problematic when the individual providing the advice can be viewed as being in a “position of power” over the patient. Do you understand that you could be held personally liable for making rendering such advice if that advice has adverse consequences? And you wouldn’t have a legal leg to stand on.

You had to look the device up on WebMD. That tells me you don’t know a thing about them. Before you begin rendering medical advice based on an outdated WebMD article, you should be aware of a few things. There are several different such devices out there. They look different, and may function in different ways; it’s a rapidly evolving field. Do you understand that passing a CGM through an x-ray is likely to disrupt the interaction between the sensor and the monitoring device? (This raises an interesting question, btw. I haven’t the faintest idea whether passing through an MMW while wearing a CGM is disruptive to the system.) Do you understand that the distance between the sensor and the monitor affects the ability of the device to maintain accurate data? And that distance varies from model to model?

CGM’s aren’t mentioned on the Infallible TSA Website, so I have no idea whether TSA even considered them. It’s clear from posts on this thread that some travelers have had problems at checkpoints regarding insulin pumps and glucose monitors. Some have not. This is a reflection of the typical uneven experiences the public has. Either the handling of these devices is another example of inadequate training, or the training doesn’t address it at all so the individual TSO’s are winging it, or both.

If it were me, I’d be very circumspect about what sorts of medical advice I started handing out to the public.

Does TSA trump medical privacy? Why should a diabetic be forced to disclose their medical condition? Wasn't the whole point of HIPAA that you should be allowed to keep your medical conditions and history private?

I've had my gripes and complaints about the TSA - but I agree with TSO Ron's comments above.

Saying "I'm a diabetic and this is an insulin pump" is not volunteering your entire medical history. if you're carring a device THROUGH the xray you do have an obligation to give a basic description of what it is. I've never been grilled on what medications or the amount of insulin I take. If I get secondary screened I point out to the TSO that I have diabetic gear, and that's as far as it goes.

There's no reason not to disclose it, and as I mentioned in my post every TSO that has noticed my OWN insulin pump understood what it was once I told them. I was once asked to remove it. I told her they are allowed to stay one, and another TSO corrected her also and I was allowed to pass.

This is a good reference also to keep in your travel bag, or bookmark on your mobile should you have any problem.

Regarding CGMs - or "constant glucose monitors" I have one and use it about 50% of the time. Mine is a separate transmitter than I wear, and it sends my blood blood glucose number every five minutes to my insulin pump. (The Medtronic Guardian.)

A common question is if it automatically doses you insulin based on your reading, and the answer is no. It's not a "closed loop" system yet, and you don't want it to be. Your insulin pump doesn't account for future activies, like biking 10 miles or sitting in front ot the TV for six hours - so you are still required to control your insulin take via your pump.

Some CGMs aren't part of an insulin pump, yet are still carried around like a cell phone or pager. I agree that in this case an exception should be made, however if it were me I would just put it in my bag for a the two minutes I'm going through security. (Again since it's not an insulin pump they are untethered.)

here's some photos and some history from my experiences using it:http://www.futuregringo.com/index.php/2008/01/02/minimed-constant-glucose-monitor/

Medical decisions are made by medical practitioners in consultation with their patients. Advising a “pax” that it wouldn’t be a problem to remove any medical device for the brief period of screening is, legally, the provision of medical advice. It isn’t up to you to provide medical advice about what is or isn’t a problem with regard to any medical device. It’s particularly problematic when the individual providing the advice can be viewed as being in a “position of power” over the patient. Do you understand that you could be held personally liable for making rendering such advice if that advice has adverse consequences? And you wouldn’t have a legal leg to stand on.

Combined with TSORon dispensing medical advice as follows:

I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem.

Here is a perfect example of someone practicing medicine by making the judgment that our TSA friend has made.

Ron, just out of curiosity, where did you go to medical school? If you ever dispensed this type of medical advice at a checkpoint, and, if you are not authorized to practice medicine in the state in which your checkpoint is located, you could go to jail for a LONG time and possibly emerge as a convicted felon. If your employer has set you and your fellow screeners up to making such judgments, they are even more unethical and irresponsible than I can imagine.

Yet another thought: I myself have numerous times rolled my eyes at the TSA, and shook my head at "security theater." Based on this many now look at the TSA experience as a circus, and automatically they can do no right.

Sarah offers reason in her comments about her experience. The TSO Ron is trying to educate himself on CGMs and ask questions.

Yet some say "Don't ask me anything about anything."

You can't walk through security with a backpack full of Sudafed and say:

"I have a medical condition, so mind your own beeswax."

But that's how some above comments would want it.

Again, A 10 second summbary and an articulate explanation to a TSO about your condition is not the constitution crumbling at your knees. The black and white is just baffling - when a little cooperation goes a long way.

Q: What recourse does a citizen with diabetes have should a TSO decide not to allow these items on board, as TSOs did with Mr. Gel-Pack's gel pack for his wife's breast milk?

A: If a passenger finds themselves in a situation where a TSO is not allowing them to bring something that is permissible, especially if it is an item the passenger depends on to live or stay healthy, they should ask for a supervisor. If the supervisor still does not allow the item, the passenger should ask for a manager. Please note that Mr. Gel Pack’s incident, while unfortunate, is extremely rare. To read the comments here, you would gather that this happens all the time which is simply not the case. This was an isolated incident. Our workforce is properly trained on 3-1-1 exemptions. In this isolated case, they got it wrong. This is not the norm.

Q: What recourse does a citizen with diabetes have should a TSO decide they have too much insulin, as TSOs have in the past decided regarding baby food?

A: A TSO does not have the authority to judge how much medication you require or prevent you from bringing medication on a plane.

Q: What training are TSOs given regarding the needs of citizens with diabetes?

A: TSOs receive a lengthy course on passengers with disabilities during new hire training and also receive recurrent training throughout the remainder of their employment.

Q: Is a printout of this blog post considered proof of TSA's policy, or are TSOs authorized to override this at will?

A: If you found yourself in a situation where you needed it, a printout of this blog post could help your situation. Please note that the majority of information from this post was taken directly from our public page which you can print out as well.

Q: What is TSA doing to ensure that TSO's will not confiscate gel packs, cooling wallets or other devices used to cool medicines in these cases?

A: TSOs are trained on 3-1-1 exemptions.

Q: How could we get the TSA to add continuous glucose monitors to the list?

A: I’ve put it in motion and will let you know what happens.

Q: How much of your medical information do you have to share with the TSA?

A: You don’t have to share any if you don’t want to. I’ve spent some of my time attending meetings and answering travel questions for folks with various disabilities. Some very interesting discussions have come out of these meetings. Everybody agreed that when they told the TSO about their disability and what they needed, their screening went much more smoothly.

Q: Does this blog advice only work for diabetics, or are people with more unusual conditions or devices required to share more detailed medical information with the TSO?

A: This particular blog post was focused on diabetes. Future blog posts may cover other disabilities. For more travel information for passengers with disabilities, you can go here: http://is.gd/nSrX

Q: Now that this has been officially announced on the blog that the information will be immediately read by/to every TSO at the regular "shift briefs"? Or will it be carefully round-filed by the middle-managers?

A: TSOs are already trained on this information, however, I am going to link to the post on my internal blog and suggest that the info go out in the national shift brief.

Q: I have type II diabetes, however I am on medication only (Amaryl and Actos) and do not require direct injection of insulin. Will I be still allowed to keep my blood glucose meter kit (lancets, blood glucose meter, test strips, alcohol swabs, and glucose tablets) on person?

A: All of these items are fine to go through the x-ray in your carry-on luggage or they can be physically inspected.

Sara said... I am the author of the original post. It sounds like a lot of these comments are in regard to hypothetical worries. I didn't write about it in my original post that this article links to, but I have never had concern over the ice/gel packs that my insulin is packed with, the syringes (new and used), or any of my other diabetic supplies. We are truly much more common than we think. I have to remind myself that I am not the first diabetic a TSA screener (and especially their manager) has seen. There is also an interesting thread about diabetes and air travel within the Diabetes Daily forum. March 17, 2009 7:42 PM---------------------------------Nice to hear from you, Sara. Thanks for your very insightful comments. I'll be the first to admit that mistakes are made, but you are proof that they are not the norm. Thanks. ---------------------------------TSORon said... If the alarm cannot be resolved then the passenger must make a choice, remove the device or find another way to travel. March 18, 2009 6:49 AM----------------------------Ron, I think you need to take this a little further and explain that the chances of this happening are extremely, extremely rare and at no time would we ever require somebody to remove a medical device. In the rare event that this would happen, we would take every measure available to clear the device.

On this very blog post have been made demonstrating that TSO's just don't get it.

We have Mr Gel Paks notorious event. We have TSO NY, one of your highly trained TSO's, who severely misstated TSA policy regarding medical items and even in this new thread James stated that one TSO wanted him to remove his insulin pump.

Are these examples of TSA's effective training program?

How many problems are to many? Does someone have to be injured before TSA takes action and makes sure TSO's understand the training they have received? It would seem so!

Once again this is another fine example of just why a complete set of rules that travelers must comply with should be published, posted and available to all.

@Bob: If a passenger finds themselves in a situation where a TSO is not allowing them to bring something that is permissible, especially if it is an item the passenger depends on to live or stay healthy, they should ask for a supervisor. If the supervisor still does not allow the item, the passenger should ask for a manager.

Is this an official statement of TSA policy/procedure regarding escalation and passengers' rights to escalation? You do state that a printout of this blog post could help your situation. But I already have experienced two "isolated cases" that are "not the norm." Those TSOs seemed anything but amenable either to persuasion from a blog post printout or my supposed right to escalation.

I am aware of the information about travelers with disabilities on the TSA website. But I don't recall anything about an official escalation procedure, or the right of passengers to ask for a supervisor or manager. Ordinarily, citing the relevant chapter and section of an official published policy would be more persuasive. But as the TSA regards the secrecy of its policies and procedures as key to their effectiveness, that isn't available to the public. So we can only rely on statements from a TSA blogger, posted on a blog in response to public comments and hope that the TSO is persuaded. That isn't reassuring at all, especially when the consequences of encountering a TSO who is "not the norm" are so severe.

TSOs are trained on 3-1-1 exemptions.

Yes, we all know how TSOs are supposed to be trained, and what they're supposed to do. But enough of us have encountered situations contrary to how the TSA supposed to operate, to suggest that we can't always rely on TSOs being properly trained. Most TSOs probably are correctly trained. But the minority who aren't are nonetheless enough to make air travel needlessly worrisome.

This just in, this blog post will be mentioned during shift briefs nation-wide on Wednesday.

That's good. But what does "mention" actually mean? Is it specific to diabetes, or are you addressing the more general problem of ensuring that passengers who carry medications are correctly handled according to whatever (SSI?) rules apply?

Also, I think your response here is encouraging. It provides some hope that the TSA will improve its consistency and procedures so that those of us who are "exceptions" need not fear the consequences of TSO actions that are "not the norm." You've taken a step in that direction, but the road is many miles long.

Blogger Bob said:“Ron, I think you need to take this a little further and explain that the chances of this happening are extremely, extremely rare and at no time would we ever require somebody to remove a medical device. In the rare event that this would happen, we would take every measure available to clear the device.”

You are 100% correct Bob. I have never and never will require anyone who says that the device is a medical one to remove such. Nor have I ever told someone that they could not take their insulin through the checkpoint, or any other medically necessary item (as claimed by a passenger. Additionally, I have never claimed to be a medical expert, never claimed to have a medical license (as some here intentionally misconstrued my comments to mean), and so I need not worry about being party to a suit of any kind based on these claims.

But I have to admit, its kind of fun to watch some of the posters here intentionally jump off the cliff of hysterics to attempt to make a point. Thanks Bob for your efforts here.

Does this blog advice only work for diabetics, or are people with more unusual conditions or devices required to share more detailed medical information with the TSO?___________________________________

I would hope that all TSO's are the same as me. People's medical conditions are their business. Nothing has to be explained to me. If someone has concerns about going through the walk through or about what they have in their bag, all they have to state to me is,"I have a medical condition". For example they walk up and say, "I have a medical condition, there is medicine in my bag". Okay that is enough you do not have to tell me about it. If you can not take off your shoes and I ask why and you say for medical reasons. Okay that is all that you have to say. A TSO should not question anyones medical conditions.

I have type II diabetis, however I am on medication only (Amaryl and Actos) and do not require direct injection of insulin. Will I be still allowed to keep my blood glucose meter kit (lancets, blood glucose meter, test strips, alcohol swabs, and glucose tablets) on person ?___________________________________Yes you can have anything that has to do with your illness. It goes through the xray with your property.

This thread is a perfect illustration of why secret rules constitute an actual threat to the safety of passengers rather than an enhancement to security.

As things now stand any rogue TSO can totally disregard the TSA policy Blogger Bob covered in the original post (if it really is TSA policy; we can't tell for sure since it it SSI!) and the passenger has absolutely no recourse.

A simple request to "show me the written rules" is more likely to result in a civil fine than an actual peek at any written rules.

I can think of no better example of an agency run amok than one which puts people at risk to their life in order to "protect" them. Sounds sort of like, "In order to save the village, we had to destroy it."

T-the-B @flyertalk___________________________________

Nothing in this post has any relevance. What do you mean "This thread is a perfect illustration of why secret rules constitute an actual threat to the safety of passengers rather than an enhancement to security"?There are no secret rules about medicine or anything for that matter. This blog states the rules. Its no secret that there are TSO's that have no clue what they are doing and take passengers items that they should not. That is not a secret rule, it is stupidity! I know the reason that the request of knowledge of secret rules is not given to the public. Because there are not secret rules. Just the ones plainly stated on the TSA web page. Read them and stop the broken record routine.

Bob said "Ron, I think you need to take this a little further and explain that the chances of this happening are extremely, extremely rare and at no time would we ever require somebody to remove a medical device. In the rare event that this would happen, we would take every measure available to clear the device."

I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem.

Here is a perfect example of someone practicing medicine by making the judgment that our TSA friend has made.

Ron, just out of curiosity, where did you go to medical school? If you ever dispensed this type of medical advice at a checkpoint, and, if you are not authorized to practice medicine in the state in which your checkpoint is located, you could go to jail for a LONG time and possibly emerge as a convicted felon. If your employer has set you and your fellow screeners up to making such judgments, they are even more unethical and irresponsible than I can imagine.___________________________________

Oh Harry Nicholson, what a post! You must be a lawyer, along with every other person preaching the LAW on here. If you ask Ron where he went to medical school, then I ask you Mr. Nicholson, where did you attend LAW school?I am pretty sure that Ron has not tried to practice medicine. In fact the first words he stated are, "I would think". Now that does not sound like someone practicing medicine to me. It sounds like someone who is inquiring about something and simply stating what they think may be correct. And if he is incorrect, then may he be corrected. But not ridiculed because he is trying to understand the subject. Everyone on here is so judgmental. At least Ron has the nerve to post with his name and job title. That is more than I could say for me. For one I would not want to be ridiculed by name like Ron and for two it is no ones business who I am.Thanks Harry and everyone giving there legal advise.

He is right. A TSO should not question your medical condition unless he has good reason to believe you are being suspicious. Gel packs to cool medicine is medical and is exempt from the 3-1-1 rule. If a passenger has any sort of medical device on them and by chance are asked if they are able to remove it, all they should have to do is say no I can not remove it. Of course this means they have to experience a hand wanding or pat down because they are going to set off the WTMD. I am a TSO going on 8 months now and I gotta say, most of these stories of horrible TSO's I have heard of come from large airports. TSO's at checkpoints being put under stress by the airlines and passengers to get nearly 2000 people through 1 checkpoint in 8 hours. Passengers yelling at them to hurry, children creating chaos and distractions, everyone shout in their heads "I am not a bad guy just let me through!". All we ask for as TSO's is to please be calm, relax, the rules are posted on signs, pay attention to whats going on and we will work to get everyone through calmly and orderly. If you get a TSO who is a jerk then grab a supervisor, doesn't even have to be the one on that checkpoint, and write him up so we can fire him. We do not want people like that working for us. In TSOrons case obviously he needs more education on medical devices, so help us TSO's by telling us about your device while your at the checkpoint most of us are willing to learn and the more we learn the better we can do our job.

"I would hope that all TSO's are the same as me. People's medical conditions are their business. Nothing has to be explained to me. If someone has concerns about going through the walk through or about what they have in their bag, all they have to state to me is,"I have a medical condition". For example they walk up and say, "I have a medical condition, there is medicine in my bag". Okay that is enough you do not have to tell me about it. If you can not take off your shoes and I ask why and you say for medical reasons. Okay that is all that you have to say. A TSO should not question anyones medical conditions."

Blogger Bob wrote...TSORon said... "If the alarm cannot be resolved then the passenger must make a choice, remove the device or find another way to travel. March 18, 2009 6:49 AM"----------------------------Ron, I think you need to take this a little further and explain that the chances of this happening are extremely, extremely rare and at no time would we ever require somebody to remove a medical device. In the rare event that this would happen, we would take every measure available to clear the device.________________

Bob, I believe you are correct on that in most cases, but I'm just not sure that "TSORon, Blog MD," would really go the extra distance to clear the device/passenger instead of just playing unbending automaton "If the alarm cannot be resolved then the passenger must make a choice, remove the device or find another way to travel. I know, not the answer that anyone here is going to like, but facts are facts. I don’t make the policies, I just enforce them."

From the record of comments TSORon has made over time on this blog, I would not trust the quality of the results.________________

Thank you very much, Blogger Bob, for getting in here and directly responding to some of the questions from the public in this topic. This is much more how I would envision a useful "dialogue" to be here on EoS.

TSORon said:"But I have to admit, its kind of fun to watch some of the posters here intentionally jump off the cliff of hysterics to attempt to make a point."

You know, being accused of hysteria is very patronizing, as any woman who grew up in the '60s, '70s and '80s could tell you. Now it's being applied to anyone who disagrees with you. Perhaps your statements would come across as more understanding of the passengers' concerns if you avoided the patronizing attitude.

"TSORon said... If the alarm cannot be resolved then the passenger must make a choice, remove the device or find another way to travel. March 18, 2009 6:49 AM----------------------------Ron, I think you need to take this a little further and explain that the chances of this happening are extremely, extremely rare and at no time would we ever require somebody to remove a medical device. In the rare event that this would happen, we would take every measure available to clear the device."

Thank you, Bob.

Now, do you think you could train your employees to drop the "do you want to fly today" routine?

I'm not a lawyer, Anon, and I don't even play one on TV. I am, however, a public health official and a certified EMT in my "spare" time.

They've probably changed the book since I took my first class many years ago, but I still recall day one, chapter one. What do you think it was called? Chapter One: "How to Save A Life"? Nope. Chapter One: "Anatomy"? Nope. Chapter One: "Rescue"? Nope.

"I am the author of the original post. It sounds like a lot of these comments are in regard to hypothetical worries. I didn't write about it in my original post that this article links to, but I have never had concern over the ice/gel packs that my insulin is packed with, the syringes (new and used), or any of my other diabetic supplies."

I'm glad you haven't had a problem, Sara -- but other posters on this blog who are also diabetic apparently have. This is a good topic, though -- at least TSORon may have learned something about diabetes, even if his information is (or was) woefully incomplete.

There are a lot of diabetics out there, and the more aware TSO's are, the less likely it is that one of those unfortunate incidents will be repeated. I've very glad to hear from Bob that this subject will be added to shift briefs.

Thank you very much, Blogger Bob, for getting in here and directly responding to some of the questions from the public in this topic. This is much more how I would envision a useful "dialogue" to be here on EoS.

Tom (1 of 5-6)I couldn't agree more, I was very surprised when you answered some of the questions that have been brought up in this thread. Something that has rarely happened in the past and should be how this blog works.

Whenever possible take the train. By the time you learn all the TSA rules, regulation and exceptions as well as the TSO's misinterpretations of same, you might as well have sought alternative travel. It is easier to fill out a tax return than figure out TSA methods.

I have a condition that can cause me to be severely dehydrated very quickly if I do not frequently consume liquids. Does this mean the 3.4-1-1 does not apply to me? How do I prove this without giving away my medical history?

A. Librarian said:"Perhaps your statements would come across as more understanding of the passengers' concerns if you avoided the patronizing attitude."

I was going to give another glib reply, but that would not be appropriate. The over exaggerated responses that are so common here are also common in Usenet and it seems on other blogs. My attitude here for the actual passengers is to support them in their quest for knowledge. My attitude for those who use this forum to toss hysterical hypothetical scenario’s is that they are here to bait people, misrepresent the TSA’s mission, and misrepresent the actions of the TSO’s who work so hard each day to get those 2 million passengers through the checkpoints around the nation. Which are you?

Medical conditions are very very common on the checkpoint. We know how to deal with them. But understand, people with medical conditions must still be screened. We are not doctors or other medical personnel, and you know more about your condition and medical equipment than we do, so if we ask questions just answer them. We don’t do it to embarrass people, or to belittle them, but to make absolutely sure that the screening experience for you meets any needs you may have and the need for the safety of those you are flying with. You are not the only one getting on that plane, and the other passengers depend on us to ensure that everyone else on the plane is just as safe to fly with as they are.

Civilian aircraft security is an evolving science. It cannot afford to remain static since the terrorists are always looking for ways to create another 9/11. We TSO’s are learning, every single day. Not just how to find weapons but also how to deal with the people who are not terrorists. The regular guy’s and gal’s who fly. Each one is different, different as night and day. Each has their own agenda, but they all have one thing in common as well, getting to their destination safely. The TSA is determined to make that happen. I am determined to make that happen.

Fact is ladies and gentlemen, if an alarm cannot be cleared, the passenger does not fly. The TSA catches as many as 15 firearms on check points every week. And we cant even count how many other weapons, we usually measure them by the ton. Every single individual who gets caught with a gun in their bag claims that they didn’t know it was there. How apt are you to believe that? I have a tough time with that one myself.

First of all, the term is a medical term, and calling someone whom you've never met "hysterical" is inappropriate. It borders on making a medical diagnosis, which I suspect very few of us here have the training to make. (I don't.)

Secondly, many people consider the term a perjorative one, because hysteria used to be diagnosed exclusively in women. (The word derives from the Greek word hystera, meaning uterus.) For much of its history, the term was used to attribute distress in women to sexual dissatisfaction ... which is patronizing at best.

Third, the term simply distracts from the facts under discussion. You claim that the scenarios posted by many TSA critics here are unreasonable; many TSA critics would claim the same thing about the threats TSA cites but will not provide details about due to security concerns. Calling each other names doesn't help anyone.

I have had many of these devices come through the checkpoint and in my experience if the individual with the device does a good divest of metal items prior to entering the WTMD they will not normally ring. If the individual does ring, we can work with them at the WTMD to ascertain if there are other items that might cause them to alarm. If no further items are found that would normally cause an alarm, we refer them to additional screening. When they go into the additional screening area, they are hand wanded (unless they have another medical implant that would prevent this), and the alarms are cleared accordingly. The only thing that has been out of the norm that I have seen was testing of the equipment by ETD. I have a fairly small airport and we are lucky enough to be able to take more time than the larger airports, but the basic process should not be chenged much. the worst a passenger with one of these devices should endure would be the full pat down, followed by an ETD of the item itself.

Literary critic Elaine Showalter, who describes the history of madness and hysteria in women in literature, says in her book "Hystories":

"...many assume the term hysteria has insulting connotations. Being hysterical means being overemotional, irresponsible, and feminine. During an argument, "hysterical" is what you contemptuously call your opponent when you're keeping your cool and he's losing his. It's a term that particularly enrages some feminists because for centuries it has been used to ridicule and trivialize women's medical and political complaints."

Whenever possible take the train. By the time you learn all the TSA rules, regulation and exceptions as well as the TSO's misinterpretations of same, you might as well have sought alternative travel. It is easier to fill out a tax return than figure out TSA methods.

If you cannot avoid commercial air travel, I pity you.

_________________________

That's great for someone who has unlimited free time to spend days on Amtrak, or never travels overseas.

I'm 34 with a full time job, and make the most of my vacation time. I spend weekends in New York, visit friends in Chicago, and take many weekend trips.

As mentioned above I've been disgusted by security theater in the past, but it's not going to impede my love of traveling, and someone that uses the TSA as an excuse not to traveling is, well, just making excuses to never leave their house.

I have a condition that can cause me to be severely dehydrated very quickly if I do not frequently consume liquids. Does this mean the 3.4-1-1 does not apply to me? How do I prove this without giving away my medical history?___________________________________

You should be able to say just that. Period. We are not supposed to question anyone. But really, they sell liquids on the inside. So as far as I am concerned no one needs to walk in with them.

I'm not a lawyer, Anon, and I don't even play one on TV. I am, however, a public health official and a certified EMT in my "spare" time.

They've probably changed the book since I took my first class many years ago, but I still recall day one, chapter one. What do you think it was called? Chapter One: "How to Save A Life"? Nope. Chapter One: "Anatomy"? Nope. Chapter One: "Rescue"? Nope.

Sandra said... Anonymous, one doesn't have to be a lawyer to know that practicing medicine without a license is not legal and the consequences of such are as Harry wrote.___________________________________

You people are funny! I wonder what kind of positions you hold.

Oh and no one is practicing medicine on the checkpoints, but your concerns are greatly appreciated!

TSORon said:"But I have to admit, its kind of fun to watch some of the posters here intentionally jump off the cliff of hysterics to attempt to make a point."

You know, being accused of hysteria is very patronizing, as any woman who grew up in the '60s, '70s and '80s could tell you. Now it's being applied to anyone who disagrees with you. Perhaps your statements would come across as more understanding of the passengers' concerns if you avoided the patronizing attitude.___________________________________

Hysterics, hmm a figure of speech. A word used to define someone who over exaggerates. Thats what I think. Ron, no offense taken.The over reaction of the people on this site is rediculous and quite funny. They can cut you to peices and don't you dare use the wrong verbage or spell a word wrong. Because they will be all over you! Don't you dare give your opinion back because they don't like that.Librarian, I am asuming that is your profession. If so maybe you should go read a good book. :)

@TSOREED: ...most of these stories of horrible TSO's I have heard of come from large airports. TSO's at checkpoints being put under stress by the airlines and passengers to get nearly 2000 people through 1 checkpoint in 8 hours.... help us TSO's by telling us about your device while your at the checkpoint most of us are willing to learn and the more we learn the better we can do our job.

Thanks for your perspective. But these two statements seem contradictory. A TSO under the stress of competing pressures to keep all Prohibited Items du jour off planes while not impeding the orderly flow of human livestock through the checkpoints to the holding pens probably would not be interested in holding things up to "learn" anything a passenger might try to "teach" them.

And besides, TSOs are thoroughly trained. They already know the rules (including whatever unpublished local rules are in effect at that airport at that moment). A passenger who tries to "teach" or "explain" something contrary to what the TSO knows (or believes, or "interprets") is obviously trying to sneak through a violation. So they need to be punished and taught a lesson about respecting authority. And quickly, since it's holding up the line!

If you get a TSO who is a jerk then grab a supervisor, doesn't even have to be the one on that checkpoint, and write him up so we can fire him. We do not want people like that working for us.

Will that actually get the jerk fired? Or will it merely cause the passenger more trouble, get him or her on the no-fly list, or otherwise teach the passenger that the guy in an itchy uniform is NEVER to be challenged? Has any TSO ever been fired because passengers have complained to a supervisor?

I have to ask that because everything I've seen suggests that the TSA's culture does nothing to discourage jerks, and in fact stands behind them if their actions create embarrassment for the agency. I'm judging this by the way the TSA has reacted to incidents like the nipple-piercing case. The TSA issues a press release officially exonerating the TSOs of any wrongdoing and even praising them for the excellent work at protecting aviation. That gives no confidence at all that complaining would accomplish anything. And with all the secrecy associated with the Homeland Security bureaucracy, it's impossible to know whether a complainer might get added to some unaccountable watch list. That's why so many passengers feel they have no choice but to accept a jerk's abuse and obey-- if they want to fly today.

You should be able to say just that. Period. We are not supposed to question anyone. But really, they sell liquids on the inside. So as far as I am concerned no one needs to walk in with them.

Anonymous TSOAs far as Im concerned as a trained health care professional you are practicing medicine without a license by making that comment and seriously shows how much you dont know just along the lines of CGM and TSO Ron.

Dehydration is very a serious concern with traveling by air as the thin low pressure air pulls moisture from the body which leads to dehydration and increased risk of DVT on longer flights because the blood thickens due to volume depletion.

Personally when im working on the ambulance its not uncommon for me to drink 2+ gallons of water a day(higher when its warmer). This is my normal intake of water and when i travel its even higher because I really dont want to end up with DVT. This is why i would rather carry it with me then rely on the airlines to keep me adequately hydrated with a single 4 oz of liquid per every two hours if that. BTW on a aircraft it has to be bottled water because the "stil" water on the inboard tanks on the aircraft are questionable quality at best and probably about as sanitary as the TSA Checkpoints i have conducted bacteria swabs in the past 2 years.

That and I have had a MrGelpacks style incident when my empty gatorade bottles with literally no more then 2 drops in the bottle stolen from me at DFW term C. When i protested I was threatend with "Do you want to fly today" by a no striper who was younger then me. I didnt have time to argue as my flight was boarding at final call yeah real slow security (no joke 2 minutes per passenger at the TDC as the screener was scrutinizing everything including boarding passes) lines as it took me over 90 minutes to check in and get through security at 6am on a saturday.

Yeah that trip really sucked as when i got to my destination I was really hurting because on both flights I didnt have my 4 1 qt bottles with me to keep me hydrated and I wasnt able to get enough water during the flight as I had already drank 2/3 of the bottled water supply on the flight. I arrived at my destination in poor shape and I had to have a really good friend of mine who is also a paramedic start a IV on me and run 2 liters of Normal Saline, plus a electrolyte "Banana Bag" along with anti-vomiting medications before I even started to feel half decent. I doubt many people have access to resources like that and most likely would need to call 911 or go to the ER to be treated.

Then lets not go into the fact that air side liquids that were never screened in the first place. I have seen deliveries come though without any checking, so whats the difference between the sealed bottled water in those deliveries and the ones i have in my bag? That and they are way over priced compared to what i can get prior to getting to the airport.

"Now, do you think you could train your employees to drop the "do you want to fly today" routine?"

I second this. We were given this line when we first started back in 2002, and it's clear it's alwayd the wrong thing to say. It's not even up to a TSO, as this decision can only be made highter up the chain of command. Any TSO who sez this outta be written up, as well as anybody yelling at the checkpoint (my pet peeve).

In responce to Chris Boyce...I would love to know when a TSO has put you in a situation that you must get a LEO involved. If you're encountering a situation that needs to get a LEO involved on a checkpoint, its probably b/c you're the problem.

I'm not a lawyer, Anon, and I don't even play one on TV. I am, however, a public health official and a certified EMT in my "spare" time.

They've probably changed the book since I took my first class many years ago, but I still recall day one, chapter one. What do you think it was called? Chapter One: "How to Save A Life"? Nope. Chapter One: "Anatomy"? Nope. Chapter One: "Rescue"? Nope.

It was called Chapter One: "Medical-Legal Considerations".

Irish__________________________________

Whats your point?!

My point is: You just don't get it and your agency doesn't get it.

It's going to take either one of you screeners killing a passenger by medically harassing them into agreeing to do something medically stupid, or a disabled passenger making an example of one of you by sending you to prison for practicing medicine without a license to get your attention.

I would like to gently suggest that the attitude displayed by the person posting as TSORon (and we have no way of knowing if this is a person affiliated with your organization, or is just an internet troll) demonstrates the type of attitude that so many of us rail against.

The judgmental posts, the macho rent-a-cop attitude that the poster presents is highly stereotypical (and makes me lean towards the belief this is not a TSA employee).

Yet, there is really a lesson in all of this. You can have all the well meaning, honest employees in the world, and one jerk, one thief, or one power-tripper on the payroll, and undo all of the good of your other employees.

Certainly I'm no fan of your organization, or its leadership -- and I refuse to fly because of it -- but I'll be the first to tell you that if TSO Ron is really part of your world, someone needs to take his/her keyboard away.

Similarly, some of the TSA people who post anonymously do tremendous harm with their smarmy comments. Yes, some of us who sign our names (handles) get mightily smarmy on occasion -- but at least you know who we are and where we are coming from. Every time one of your employees posts anonymously in a smarmy manner -- they are contributing to your bad image.

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"A: No. You can opt out for WTMD screening and when necessary you may get a pat-down."

Okay, now you've confused me, Bob. The Infallible TSA Website says:

. . . those who do not wish to receive millimeter wave screening will undergo metal detector screening and a pat-down.

"and a pat-down." Period. Not "and a pat-down when necessary"

"will undergo", not "may undergo"

So, what's the real skinny? According to you, my grandchildren (five of them - ranging in age from 13 months to 12 years) "MAY" get patted down". According to the Infallible Website, they "WILL get patted down". I don't see any exceptions there.

I would like to see DYWTFT leave the organizations lexicon as well. It is inflamatory and useless, there are much better reasoned, more informative ways to resolve situations. The organization rolled out the new Engage and Coach training nationwide and it should be gaining some traction even in the bigger airports.

The over reaction of the people on this site is rediculous and quite funny. They can cut you to peices and don't you dare use the wrong verbage or spell a word wrong. Because they will be all over you!

We expect that participants will treat each other, as well as our agency and our employees, with respect. We will not post comments that contain vulgar or abusive language; personal attacks of any kind; or offensive terms that target specific ethnic or racial groups.

For many people, particularly women, the term "hysteria" is an offensive term that particularly denigrates women. I think it's perfectly consistent with blog policy to ask participants to use a different word.

Thanks for answering, but I am still confused. You say small children and parents with them can use "the walk through metal detector screening procedures". However, it seems that at airports using MMW as a primary screening tool, WTMD is combined with a pat down.

Yes that was a contradictory statement sorry I wasn't clear enough for you. If passengers are calm relaxed follow the rules and pay attention the lines through security go ALOT faster. When you have passengers freak out because your taking their toothpaste away it holds up the line and ruins everyones day. We had a passenger actually empty his entire tube of toothpaste into his mouth before throwing it away. we didn't stop him but he made a hell of a mess at our checkpoint and we had to clean it up before we were able to move people through again. You also took my learning comment a little to far. If a person comes through and says I have a medical device most good TSO's ask questions about it. What does it do? Is it metalic? Does the item have any protruding wires? Will it be affected by magnetic fields, whatever. We don't want a medical explination on your condition and how it works just enough information for us to do our job professionaly and without incident. Now that TSO knows what a glucose monitor is and how to screen it properly, which is all that matters. Now for the firing the jerk comment. Of course like any organization, the higher ups will want to back up their employees thats just how it works. But if you send the word far enough up the chain I assure you that jerk will either get a big attitude adjustment or a new job. probably behind a desk somewhere or in a dungeon tossing bags. It does cost a lot of money to train us TSO's so it will take either a big screw up or a ton of little ones to get someone fired. Here is the trick though. During our new fancy evolution training, the first thing the instructors told us was that if you don't or can't follow this new road we are going down then we are not going to keep you with us. Me being the small airport TSO that I am, I have no actual idea if they have enforced that comment but I do hope so. Im all for backing up my co-workers but that still doesn't mean I dont blow up on sea-tac TSO's that dont understand my Girl friend does not have a shirt on underneath her sweater.

We expect that participants will treat each other, as well as our agency and our employees, with respect. We will not post comments that contain vulgar or abusive language; personal attacks of any kind; or offensive terms that target specific ethnic or racial groups.

For many people, particularly women, the term "hysteria" is an offensive term that particularly denigrates women. I think it's perfectly consistent with blog policy to ask participants to use a different word."

Read the passage you are quoting!Specifically: "or offensive terms that target specific ethnic or racial groups."

Sorry, bub, but "many people" is not a specific group AND not ALL women and not particularly women are offended by this. Some people will be upset by any word no matter what it is. Stop picking nits and concentrate on the important things!

"Currently, 18 airports have millimeter wave equipment installed at checkpoints ... At these airports, randomly selected passengers and those requiring secondary screening can be screened by millimeter wave technology as a non-invasive alternative to a pat-down from an officer.

"In Tulsa, instead of walking through the metal detector, passengers will go directly through the millimeter wave machine. A passenger can opt not to go through the unit, but will go through the metal detector and get a pat-down instead."

Today, in response to repeated requests oven the past month for a description of policies regarding patting down or strip-searching children, Bob wrote the same thing he wrote in the comments for a different post:

"You can opt out for WTMD screening and when necessary you may get a pat-down."

Bob, your answer is extremely misleading. Previously, you said that people would be presented with two alternatives: 1) pat-down, 2) electronic strip search. There was no "may" about it.

Is it or is it not the case that at the 19 aforementioned airports, everyone, including children, who wishes to pass through TSA's checkpoint will be subject either to a pat-down or to electronic imaging that allows operators to see through that person's clothing?

George: "No, I really don't want to fly today. I hate spending two hours standing in queues at crowded airports. I dread being herded like cattle to slaughter by airlines before being wedged into a middle seat for five hours. I also dread standing at the crowded baggage reclaim carousel for an hour and not seeing the bag they charged me $15 to check. I resent your inept agency treating me like a prisoner, which now includes a strip search. And now you're telling me that the one-ounce bottle of sunscreen in my Victory Baggie is prohibited because it doesn't have a manufacturer's label, even though your website doesn't say anything about manufacturer's labels. And you're also taking away my crystal solid deodorant because it's supposed to be in a Victory Baggie, even though it's a solid that doesn't need to be in a Victory Baggie.

"No, I don't want to fly today. But I'd have to take three trains and two buses (each way) if I went on Amtrak-- assuming I don't miss one of the connections because the train is late. And I don't have a week and a half to drive myself across the country and back. So I have no choice. I have to fly today. And I have no choice but to give you my sunscreen and deodorant. Here. Take them.

"Oh... I almost forgot. Thank you. I really appreciate the excellent job you and the rest of the TSA are doing to keep aviation so safe and so secure."

You should be able to say just that. Period. We are not supposed to question anyone. But really, they sell liquids on the inside. So as far as I am concerned no one needs to walk in with them.

Anonymous TSOAs far as Im concerned as a trained health care professional you are practicing medicine without a license by making that comment and seriously shows how much you dont know just along the lines of CGM and TSO Ron.

Dehydration is very a serious concern with traveling by air as the thin low pressure air pulls moisture from the body which leads to dehydration and increased risk of DVT on longer flights because the blood thickens due to volume depletion.___________________________________

Wow you are a very smart person. The accusations are terribly wrong. Practicing medicine, HA.There is no medicine being practiced only a statement being told. Maybe what you don't understand is that they sell liquids of all kinds inside the terminal. Its like a smorgasbord of liquids. Really. You can stay hydrated till your little hearts content!

Fact is ladies and gentlemen, if an alarm cannot be cleared, the passenger does not fly.

So a plate in the head, rod in femur, etc, would result in not being able to fly through your airport?

Time for the ADA lawsuits against TSA to start.___________________________________

Wow what a concept. Lets see...... A person with metal in there body can be cleared. That is why there are pat downs. Really did you think before you wrote this?! Maybe you should start a suit, and represent yourself. Do it, it would definately go somewhere.

Anonymous said... Bob, Why do you even allow non sense like this to be posted. March 23, 2009 1:23 PM-------------------------You should see the stuff I delete. Somebody just told me they hope I die of head cancer. Good stuff! :) My honest advice for TSOs and Passengers is not to read the comments if you don't have thick skin. It will eat you up if you're feelings get hurt easily. :)

Well George,The reason they want you to surrender your deodorant stick is either:

They can't actually tell if it is deodorant, or a mislabeled explosive such as Dr. Perdition's Petard Primer Powder and are just erring on the side of safety, since they don't want to miss a precursor bunker buster primer, and risk getting chewed out by their supervisor....OR they actually don't care if you lose your job because you offended someone later during your trip.

For many people, particularly women, the term "hysteria" is an offensive term that particularly denigrates women.

Anonymous responded:

Read the passage you are quoting! Specifically: "or offensive terms that target specific ethnic or racial groups." "Hysteria" does not target any SPECIFIC ethnic or racial group!

Yes, gender is not an ethnic or racial group. Does that mean that I'm free to use every sexist, chauvinist, misogynist term I can in my responses? And even if I'm free to use those words, does that make it right to use those words?

All I'm saying is that avoiding this particular word would be within the spirit of the Comment Policy. Many women find the term personally offensive. Many men do as well.

Stop picking nits and concentrate on the important things!

If we can't get the little things right, we have absolutely no hope of getting the big things right.

I don't know, I do not use a BYETTA pen. Maybe your doctor can answer that question for you. I wouldn't dare give you medical advise. But I will tell you that however it is stored the TSA will accept that.

You should see the stuff I delete. Somebody just told me they hope I die of head cancer. Good stuff! :) My honest advice for TSOs and Passengers is not to read the comments if you don't have thick skin. It will eat you up if you're feelings get hurt easily. :)

Bob

EoS Blog Team

LOL! I can imagine you see some pretty nasty stuff. Thanks for filtering.

"For many people, particularly women, the term "hysteria" is an offensive term that particularly denigrates women. I think it's perfectly consistent with blog policy to ask participants to use a different word."

"You should see the stuff I delete. Somebody just told me they hope I die of head cancer. Good stuff! :) "

I would never wish that on you, Bob. (What is "head cancer", anyway? Whatever it is, it sounds dreadful.)

But, I must confess -- when you equivocated on whether my grandchildren would be subjected to a pat down (still no straight answer, btw), I did briefly wish a paper cut on your mouse-button finger. I do hope you're okay!

Bob said....You should see the stuff I delete. Somebody just told me they hope I die of head cancer. Good stuff! :) My honest advice for TSOs and Passengers is not to read the comments if you don't have thick skin. It will eat you up if you're feelings get hurt easily. :)

Bob

I can only imagine.... Thanks for being here, despite the fact that I disagree with much of what your agency does.

beyond sniping part of my post where i explained what happened to me because my bottles were stolen from me. The other one is that I refuse to by bottled water as its not really that good for you or your teeth. In some cases can cause damage to your teeth and there are clinical studies backed by peer review to back the research unlike the liquids ban TSA has instituted.

yeah If i hadn't hadn't have a friend and fellow paramedic meeting me at the end of my series of flights I would have had to go to the emergency room to get treated for severe dehydration which would have been a $2,000 bill due to the stupidity based on non-reality based science of a government entity.

Then answer me this. Other then being extremely over priced. What is the difference between the OEM sealed Gatorade's and other Bottled Water and the same items that go through a checkpoint unchecked or screened just like the cargo that goes underneath the plane? That and the bottles didn't have 3+ oz in it it was literally 2 drops in each.

@Dunstan: The reason they want you to surrender your deodorant stick is either: They can't actually tell if it is deodorant... OR they actually don't care if you lose your job because you offended someone later during your trip.

While the TSO in question obviously didn't care about how the confiscation might affect me, I'm pretty sure it wasn't because he couldn't tell if it was deodorant. He said that all deodorant has to be in the Freedom Baggie. And when I told him that my deodorant was solid, so it wasn't subject to the rules on liquids, he saw that as an entirely unacceptable challenge to his Authority and demanded that I surrender it "if you want to fly today."

My best guess (based on what he said) is that he believed that all deodorant was a "liquid" and therefore needed to be in the Freedom Baggie. I don't know whether that was how he was trained, or merely that he was drowsy, daydreaming, or preoccupied with eating a doughnut during the section of War on Liquids training that concerned deodorant. Either way, he made no attempt to inspect the item. He was a good little robot mindlessly enforcing a rule, as he understood or "interpreted" it. And he had no tolerance in any argument or "education" from me. He mindlessly followed the Standard TSA Protocol for cutting short any discussion with "... if you want to fly today." I'm sure it greatly enhanced aviation security, although the reason why it did is SSI (so that neither the Enemy nor the passenger can know it).

Since this was my second encounter with a TSO inappropriately confiscating an item (and also with answering my protest with "you'll give it to me NOW if you want to fly today"), I can only believe that the TSA management encourages this type of behavior, or at least does nothing hold the "bad apples" accountable. So I am very much afraid of even trying to take my medication and cooler through a checkpoint.

I am, however, very much looking forward to the road trip I'm planning in May. (I wonder how many people have been killed or severely injured in traffic accidents because bad experiences with the TSA made them decide to drive rather than fly?)

@TSOJoe: We were given this line when we first started back in 2002, and it's clear it's alwayd the wrong thing to say.

Can you elaborate on this? Do you actually mean the TSA trained you to tell passengers to obey if they want to fly today? I've had two TSOs say that to me when I showed unacceptable reluctance to comply with an order to surrender items I believed were permitted, so I can believe that it's some kind of common approach. But is it actually an official part of TSO training? And are TSOs still being trained to say that?

(I know that's probably SSI. It would be truly horrible if al-Qaeda trained its martyrs to resist TSOs who ask if they want to fly today.)

I brought up the point about the word "hysteria" because I know that words have power.

I think it's pretty obvious now that the frequent use of words with significant subtext (like "hysteria") to put down the ideas of people who disagree with them reveals the lack of respect that some individuals have for the public and their concerns.

The word “Hysteria” actually has several meanings according to the Merriam-Webster dictionary, and the original meaning from the 1800’s no longer has any relevance in today’s society. We know better now. My use of the term was a description of the type of nonsense posts that misrepresent a specific word or phrase posted by someone else because the poster cannot find a rational point to make concerning another individuals position. Was it directed specifically at women? Not hardly, unless the poster in question happens to be female. Kind of hard to determine an individuals gender from where I am sitting.

I have quite a bit of experience posting to Usenet and this type of posting is not just common there but is in some groups a standard practice. It’s a strong indicator that the individual making the post either does not have the data to support their position or cannot admit the other poster has a valid point that cannot be argued against. If someone chooses to take a specific word or phrase personally then it is a choice they have made and I cannot be held responsible for the decision. If the individuals here could chose to post without the “leaps off the edge of reason” the conversation might turn out to be a bit more productive and the information provided (by passengers as well as TSO’s) useful to all. Both groups have a vested interest in keeping the other informed of issues and changes. Both groups can learn from the other, as long as the flow of information is not impeded by the type of hysteric posting that some here enjoy.

George @ "I am, however, very much looking forward to the road trip I'm planning in May. (I wonder how many people have been killed or severely injured in traffic accidents because bad experiences with the TSA made them decide to drive rather than fly?)"

What are TSA's policies regarding pat-downs and how are they serving a security need?“Transportation security officers (TSOs) use the front of the hand to screen a passenger's entire back and abdomen, the arms from shoulder to wrist and legs from mid-thigh to ankle. TSOs communicate with the passenger and explain the process prior to conducting the search. Pat-downs are conducted by TSOs of the same gender whenever possible and private screenings are available at the passenger's request. Patting down the chest area may be conducted if there is an alarm from a hand-held metal detector or an irregularity in the person's clothing outline. TSOs conduct the inspections in a professional, respectful manner, while maintaining the highest security standards.”

Mr. Gel-pack, the figure you cited of 100 fatalities by 2003 (from the paper abstract) is misleadingly low. In the actual paper, the authors estimate that "in the 4th quarter of 2002 approximately129 individuals died in automobile accidents which resulted from travelerssubstituting driving for flying in response to inconvenience associated with baggage screening." While I find the paper heavy on speculation and mathematical legerdemain, it's clear that TSA hassles have created an unknown but probably significant number of traffic fatalities when people choose to drive rather than fly, particularly for short trips where flying could take as long as driving.

The number is probably higher than it was in 2002, since overall degradation in the "air travel experience" has made other aspects of flying more onerous than TSA screening. Last year's precipitous drop in the value of the dollar and the "staycation trend" most likely encouraged more people to take road trips rather than international vacations they could no longer afford. All those confounding factors make estimating the number of people the TSA has killed all but impossible.

Still, my completely speculative guess is that by now the number of fatalities caused by people choosing to drive rather than be barked at by the TSA likely exceeds the 9/11 death toll. Again, the actual number is impossible to estimate with any accuracy, but it is a cost associated with the TSA that needs to be considered if and when someone does an impartial cost-benefit analysis.

(Those TSA boosters are only insisting that if we can't unquestioningly and gratefully accept everything the TSA, we should be quiet and stay home so it doesn't spoil the reassuring security theater for those who do accept it. I also suspect your memory is off about the specific risk of driving. Your statement implies that seat belts only cut the risk of death in half. Shouldn't it be a lot more than that?)

Your child may receive a pat-down regardless if the airport has a MMW machine or not. Preparing your child is very important. Don't forget that a private screening is a option.

To anyone at TSA (not just HappyToHelp):

One of the other threads on this blog is talking about gate screenings. What happens if a family is selected for a gate screening, and the parents ask that the child's pat-down be conducted privately? I'm not sure how you conduct a private screening in a jetway.

Is this request for a private screening going to cause the family to miss their flight? If so, then this "option" isn't practical ... and in the case of missed connections, could actually cause the passenger to lose money.

I see there being no blame on the TSA because someone chooses to drive instead of dealing with TSA. That is the persons choice to drive and while it is unfortunate, the TSA did not cause the accident. It is a personal choice. Deal with TSA or drive and have higher risk of an accident. More people driving obviously will make the death toll higher from driving accidents. I would not blame the TSA for other people's actions.

Nope. No they don't. I've gotten the crotch grope from TSOs and you wonder why the bad attitude towards TSA.___________________________________

Nope. Didn't happen. Don't believe it. We don't touch crotches ever. We use the back of our hand a pat the zipper area. But a crotch grope doesn't happen. Oh I have so much more to say, but I want this to get posted.

Nope. Didn't happen. Don't believe it. We don't touch crotches ever. We use the back of our hand a pat the zipper area. But a crotch grope doesn't happen. Oh I have so much more to say, but I want this to get posted.

It happened. A TSO cupped my testicles. This wasn't recent, but it did happen.

George @"...I also suspect your memory is off about the specific risk of driving. Your statement implies that seat belts only cut the risk of death in half. Shouldn't it be a lot more than that?)"

I could very well be mistaken. The article I remember was one I read in a newspaper many years ago which tried to normalize several common activities to 1/1,000,000 risk. The 120 miles number I remember looks close to a recent 136 vehicle-miles per 1/1,000,000 fatalities, FARS says, and NTSA says 45%-60% for seatbelts. Recent airline flights seem so safe it is hard to come up with a 1/1,000,000 risk. 2-10 commercial flights?

Good read of the article. I've fallen to understating the costs, since TSA boosters won't admit that TSA has anything more than a insignificant cost. At least from the article it is clear that TSA's efforts did indeed cost lives, back when we could measure the difference between doing things with TSA and without TSA. Now all we get is TSA fluff saying how indispensible they are and hiding their half-baked analyses as high-pay-grade SSI.

James @ "I see there being no blame on the TSA because someone chooses to drive instead of dealing with TSA. That is the persons choice to drive and while it is unfortunate, the TSA did not cause the accident. It is a personal choice. Deal with TSA or drive and have higher risk of an accident. More people driving obviously will make the death toll higher from driving accidents. I would not blame the TSA for other people's actions."

I would. Especially if TSA boosters advise people to choose more risky options.

In the aggregate, TSA's security tax makes flying more expensive, pushing people to take cheaper/risker alternatives. TSA might be worthwhile if its efforts actually save at least as many lives as it costs, but to show that, TSA would have to have catch a set of 9/11 terrorists every couple years just to offset the 2,000,000 person-hours TSA asks for each day.

@James (Anonymous March 26, 2009 11:37 AM): I see there being no blame on the TSA because someone chooses to drive instead of dealing with TSA. That is the persons choice to drive and while it is unfortunate, the TSA did not cause the accident. It is a personal choice. Deal with TSA or drive and have higher risk of an accident.

That is absolutely correct. And I apologize to all the dedicated people in the TSA for implying that they are killers. However, it is undeniable that some people who have had one or more bad experiences at checkpoints do decide it's better to drive than to go through it yet again. Yes, that's entirely a personal choice. But the problems with the TSA that have been discussed ad nauseum here-- and mostly ignored-- are a very significant factor in that choice.

The TSA clearly prefers to blame passengers for everything that goes wrong, as do the airlines. But the fact is that the TSA is an unpleasant (and questionably effective) part of air travel suggests that avoiding it whenever possible is a good idea. Especially since the TSA shows no signs of doing anything to discipline, fire, or otherwise discourage the minority of "bad" TSOs who cause those bad experiences. So the choice of driving rather than flying is understandable.

My actual point is that highway fatalities that result from people choosing to avoid TSA hassles by driving rather than flying is part of the cost of the "security" the TSA provides. Like many other "soft" costs associated with "security" (e.g., liberty, privacy, dignity) this one is difficult if not impossible to either quantify or translate into dollars. But it's a cost nonetheless, and it has to be considered in evaluating the cost-effectiveness of the TSA-- if that ever happens.

And getting back to the original topic, my two experiences with "bad" TSOs deter me from flying with my refrigerated medication. The consequences of the probably-small risk of encountering another "bad" TSO are so great that the only reasonable solution is to avoid it entirely. Evidence of culture change and accountability at the TSA might change that for me, but I see no such evidence. So if I want to take a vacation longer than a week, it has to be a road trip.

@HappyToHelp (quoting from the TSA FAQ site): TSOs conduct the inspections in a professional, respectful manner, while maintaining the highest security standards.

Yes, we all know what TSOs are supposed to do. But when we're actually at the airport, we too often see (and experience) a significant disconnect between what TSOs are supposed to do and what they actually do. Admittedly, that occurs a minority of the time. But that's enough to give all TSOs a bad name, and particularly to create fearful apprehension at checkpoints.

And what recourse do we really have when a TSO fails to "conduct the inspections in a professional, respectful manner"? More than likely, it will come down to the word of the passenger (i.e., the suspected terrorist) against that of the TSO (i.e., the impeccable professional Officer). And guess who invariably wins in any such dispute?

The solution to the TSA's public relations problem is a simple one. It all comes down to accountability, including a transparent recourse process when a passenger believes he has not been handled correctly and a transparent discipline process that ensures the swift and appropriate "correction" for any "bad" TSOs. But the TSA doesn't seem interested in anything like that.

Mr. Gel-pack said...”At the checkpoint, who decides whether an item is a medical necessity or not? Is it the passenger or the TSO?”

Well sir, I can tell you that in most cases it’s a collaboration between the two. If you come to the checkpoint with a can of Pepsi and tell me that it’s a medical necessity I’m going to tell you that it cannot come into the sterile area. Also that if you absolutely must have a can of Pepsi, well you can purchase one at a vendor inside the sterile area.

On the other hand, if you come to the checkpoint and tell me that the bottle of fruit juice you have in your bag is there because you are a diabetic, then most likely I am going to get approval from the supervisor for you to take it with you, and I will advocate for you in this.

Most medically necessary items are pretty self explanatory. If it looks like a CPAP machine, then most likely it is. If it is a bottle of cough medicine, the same applies. If on the other hand you try and tell me that that bottle of beer is a medical necessity I’m going to assume that you think I’m an idiot and not allow it through. I’ll never take it from you, oh no, that’s not going to happen. But I WILL give you the choice of either abandoning it at the checkpoint or of taking it out of the sterile area and dealing with it as you please.

Mr. Gel-pack, common sense is the ruling factor. I can accept a bottle of Robitussin as a medical necessity, but don’t try to sell me a fairy tale about the bottle of scotch in your bag.

TSORon said... Mr. Gel-pack said...”At the checkpoint, who decides whether an item is a medical necessity or not? Is it the passenger or the TSO?”

Well sir, I can tell you that in most cases it’s a collaboration between the two. If you come to the checkpoint with a can of Pepsi and tell me that it’s a medical necessity I’m going to tell you that it cannot come into the sterile area. Also that if you absolutely must have a can of Pepsi, well you can purchase one at a vendor inside the sterile area.

On the other hand, if you come to the checkpoint and tell me that the bottle of fruit juice you have in your bag is there because you are a diabetic, then most likely I am going to get approval from the supervisor for you to take it with you, and I will advocate for you in this.

Most medically necessary items are pretty self explanatory. If it looks like a CPAP machine, then most likely it is. If it is a bottle of cough medicine, the same applies. If on the other hand you try and tell me that that bottle of beer is a medical necessity I’m going to assume that you think I’m an idiot and not allow it through. I’ll never take it from you, oh no, that’s not going to happen. But I WILL give you the choice of either abandoning it at the checkpoint or of taking it out of the sterile area and dealing with it as you please.

Mr. Gel-pack, common sense is the ruling factor. I can accept a bottle of Robitussin as a medical necessity, but don’t try to sell me a fairy tale about the bottle of scotch in your bag.

March 28, 2009 10:04 PM

......................So a can of Pepsi is inferior to a bottle of fruit juice for someone needing to raise blood glucose.

TSO Ron..... said.... Well sir, I can tell you that in most cases it’s a collaboration between the two. If you come to the checkpoint with a can of Pepsi and tell me that it’s a medical necessity I’m going to tell you that it cannot come into the sterile area. Also that if you absolutely must have a can of Pepsi, well you can purchase one at a vendor inside the sterile area.

On the other hand, if you come to the checkpoint and tell me that the bottle of fruit juice you have in your bag is there because you are a diabetic, then most likely I am going to get approval from the supervisor for you to take it with you, and I will advocate for you in this.

Bob could you find more about TSO Ron and train him correctly? He does not know enough if he will permit some juice and not some soda. Both have sugars and for diabetic purposes should be ok. It doesn't matter if you can buy it on the other side it is still putting TSA at liability because what if I was diabetic and could not get to the soda machine fast enough after TSO Ron took my pepsi. This is what people are talking about on the blog. TSOs assuming way too much. If the pepsi alarms that is a different story... if it doesn't stop being lazy and do your job TSO Ron.. use your equipment and clear the item for medical purposes. It is like you are saying they sell cough syrup on the other side so you can not take your cough syrup through the checkpoint. Makes no sense.

“A perfect demonstration of why TSO's are not equipped to make medical decisions.”

RB, that’s the reason that I stated, clearly, that it’s a collaboration between the passenger and the TSO. We don’t make medical judgments, which is why the decision would have absolutely nothing to do with the passengers medical needs and everything to do with an oversized liquid entering the sterile area. An oversized liquid that all passengers “should” be aware will be not allowed, and that can be purchased inside the sterile area if they absolutely have to have it. But, as the husband of a diabetic, I know that the processed sugar in Pepsi is not recommended for dealing with low blood sugar. As for what to do if you disagree, see below.

And then of course Anonymous #542 leaps, and can be heard saying as he falls:

“TSOs assuming way too much. If the pepsi alarms that is a different story... if it doesn't stop being lazy and do your job TSO Ron.”

#542, kindly reread the post. I stated, clearly, that it’s a collaboration between the passenger and the TSO. That means the two work together to come to a conclusion about the liquid. Experience says that it wont go through, as do the directives, no matter the medical claims made. But the TSO IS NOT the end of the chain. The checkpoint supervisor is the ultimate authority and if a passenger has an issue with a decision made by a TSO then they are more than welcome to speak with those in charge. Just ask. Ask.

Here’s a bit of advice for you though. When making the request to speak with a supervisor, leave the attitude outside the checkpoint. We cant deny your request to speak with the supervisor, but that supervisor is usually more likely to decide in your favor if you approach them with reason and calm than if you come with a chip on your shoulder.

I have in my time has one passenger come into the checkpoint with a major chip on his shoulder, was selected for additional screening, and began his experience by alienating the TSO assigned to the pat-down. He demanded a complaint form even before the pat-down began. At the end of the screening his words to me were “That wasn’t all that bad, I was expecting far worse based on what I have read on the web.” I asked him if he still needed the form and he declined, and thanked me for doing my job. His attitude was based on what he had read HERE, and a few other places. My point being, you are not helping your fellow traveling public by leaping off the edge of reason with your comments here.

“A perfect demonstration of why TSO's are not equipped to make medical decisions.”

RB, that’s the reason that I stated, clearly, that it’s a collaboration between the passenger and the TSO. We don’t make medical judgments, which is why the decision would have absolutely nothing to do with the passengers medical needs and everything to do with an oversized liquid entering the sterile area. An oversized liquid that all passengers “should” be aware will be not allowed, and that can be purchased inside the sterile area if they absolutely have to have it. But, as the husband of a diabetic, I know that the processed sugar in Pepsi is not recommended for dealing with low blood sugar. As for what to do if you disagree, see below.

.........................Once again your trying to change what you have already stated.

This is what you said Doctor TSORon,

"If you come to the checkpoint with a can of Pepsi and tell me that it’s a medical necessity I’m going to tell you that it cannot come into the sterile area. Also that if you absolutely must have a can of Pepsi, well you can purchase one at a vendor inside the sterile area.

On the other hand, if you come to the checkpoint and tell me that the bottle of fruit juice you have in your bag is there because you are a diabetic, then most likely I am going to get approval from the supervisor for you to take it with you, and I will advocate for you in this."

It is clear that in your professional medical opinion you think fruit juice is an acceptable choice for a diabetic but not a Pepsi.

In respect to hypoglycemia either drink, a Pepsi or fruit juice, would work about as well as the other to give a fast increase to blood glucose. Both are have large amounts of fast acting forms of sugar and will give a significant BG increase in a short period of time.

Are there other choices available? Certainly, but many people feel more comfortable with common beverages that would not draw attention to themselves instead of glucose tabs or other forms of glucose/sucrose such as the gels that are available (and probably not permitted by many TSO's).

Then in your latest post you go on to state:

"We don’t make medical judgments, which is why the decision would have absolutely nothing to do with the passengers medical needs and everything to do with an oversized liquid entering the sterile area."

If you confiscate/disallow either the Pepsi or fruit juice from a person who states they are diabetic then you have made a medical decision. You can try to spin the action anyway you want but your decision could have a negative health consequence to that person.

So you accuse me of taking a leap off the edge of reason, Doctor TSORon.

TSORon said...#542, kindly reread the post. I stated, clearly, that it’s a collaboration between the passenger and the TSO. That means the two work together to come to a conclusion about the liquid. Experience says that it wont go through, as do the directives, no matter the medical claims made. But the TSO IS NOT the end of the chain. The checkpoint supervisor is the ultimate authority and if a passenger has an issue with a decision made by a TSO then they are more than welcome to speak with those in charge. Just ask. Ask.

You can't state one thing and mean another. TSO Ron you are making me believe you do not know your job. It is scary. Says on the website that medical liquids are permitted. Your directives are different then. It is to my understanding that if I claim something as medical and you test it or whatever you do and it clears then I get to have it. I don't care what your diabetic wife uses.... I can choose to use pepsi because that is the freedom that I am given. If it is not the best choice oh well... it is an alternative to a more expensive choice. You TSO Ron need some new training I believe. BOB YOU NEED TO CLARIFY SOME STUFF! This is wrong that a TSO would choose to take away a medical liquid that is suppose to be exempt after clearing screening. And something like this also shouldn't have to have a supervisor involved. It should be more simpler than that and should be easier on the passenger than having the whole checkpoint involved on one thing a single TSO can handle.

""If you come to the checkpoint with a can of Pepsi and tell me that it’s a medical necessity I’m going to tell you that it cannot come into the sterile area."

Hey Ron, from one TSO to another: the above staement is wrong. As a diabetic, I know you are wrong. When a diabetic goes into a low sugar mode, he needs FAST sugar, preferably liquid. The choice of liquid is irrelavent. If he/she does not get it, they may laspe into a coma and die. The SOP allows a diabetic to bring said liquid through. Granted, I don't think they need a 6 pack, but a single can is fine.

"@TSOJoe: We were given this line when we first started back in 2002, and it's clear it's alwayd the wrong thing to say.

Can you elaborate on this? Do you actually mean the TSA trained you to tell passengers to obey if they want to fly today? I've had two TSOs say that to me when I showed unacceptable reluctance to comply with an order to surrender items I believed were permitted, so I can believe that it's some kind of common approach. But is it actually an official part of TSO training? And are TSOs still being trained to say that?

(I know that's probably SSI. It would be truly horrible if al-Qaeda trained its martyrs to resist TSOs who ask if they want to fly today.)"

Hello, George! I don't recall who or what outfit originally trained me. It was not TSA itself, but someone contracted to train us fast. This was back in Sept, 2002. I do recall the sense of ugency as the feeling was that the next attack could be any day. While being trained, that line would pop up, usually in response to what to say before you called a LEO. Now, the TSO does not directly call a LEO, but is to use his chain of command to resolve issues (call the Lead (2 stripers), Supervisor (3 stripes) or Manager (usually buiness clothes). I have had much training since then and for the the training done by TSA has NOT used this line. And with the Enagage/Coach training we all have received, it is not used. But it does get passed down and around.It is part of TSA's culture that should be stamped out. It's not a helpful line, it's stupid ("no, I just bought a ticket, packed and went to an airport to NOT fly today"), and it's inflammatory. Sometimes I don't WANT to fly, but have no choice. But that's just my opinion...

As a diabetic I have never had a doctor state, nor read anywhere in writings about diabeties, that softdrinks are used for medical necessity. In fact the medical community by and large encourage patients, even non-diabetics, to avoid softdrinks because of their high sugar content. That may be your beverage of choice but a soft drink is not ever going to pass as being a medically necessary liquid. Your argument is laughably ridiculous.

Hmmm, I’m sorry that I overestimated your ability to understand the concepts I am attempting to communicate. Let me see if I can clarify things for you. I’ll try to avoid using big words.

Medical liquids are allowed. Pepsi is not a medical liquid. Scotch is not a medical liquid. The list of what is and is not a medical liquid is as long as the list of possible liquids. Far to long for the TSA to list, which is why they do not try. It is also the reason they depend on the common sense of the TSO’s and STSO’s on the checkpoint. We have no vested interest in denying someone their can of Pepsi, but it is a part of the job. And you would be amazed just how far some passengers will go to get their can past the checkpoint.

Water can be considered a medical necessity, and in reality to maintain life it is, but one can also get it for free at any water fountain or bathroom in the airport. Or, if they have issues with bathrooms, they can purchase a bottle of water from a vendor inside the sterile area. Claims that the bottle of water you bring from home is a medical necessity will most likely be viewed by TSO’s as unrealistic.

We can intentionally misunderstand (big words, oops, sorry) each other all week long, but its not going to change the fact that some of the claims that something is a medical necessity are untruthful. And there is always the option, if one questions a TSO’s decision, of asking to speak with the supervisor about it. And that’s the best option for people who just don’t like the idea of someone else telling them what to do. In the end, that’s what it comes down to, we are required to tell people what to do, and some just don’t like it. Sorry, but you do have other options. Even as you walk through the metal detector, you have options. TSO’s will not force you to do anything. You may not like the options we offer, then again you have the option of turning around and walking away. Your choice.

One more thing. The rules that the TSA has are available to every passenger from the moment they begin their travel experience. From the site one books their flight on, from the travel agent, and from the moment they enter the airport, those rules are available. I have noted in my time that people tend to interpret the rules in many different ways, but rarely do they take them at face value. Passengers can all stand on what they believe are their rights, and from what I have seen here they are wrong far more often than right. Everyone, myself included, are responsible to the flying public to do our part to make security happen. As a passenger it is in your best interests to do your part, and its my job to do mine. Few people are actual experts in aircraft security, and we must all depend on those who are to make the best policy decisions possible concerning safety.

As a diabetic I have never had a doctor state, nor read anywhere in writings about diabeties, that softdrinks are used for medical necessity. In fact the medical community by and large encourage patients, even non-diabetics, to avoid softdrinks because of their high sugar content. That may be your beverage of choice but a soft drink is not ever going to pass as being a medically necessary liquid. Your argument is laughably ridiculous.

April 3, 2009 10:10 AM............................Anon, any fast acting form of sucrose/glucose would be acceptable to reverse a case of low blood glucose.

A Pepsi, orange juice, glucose gel or tabs, smarties candies and many more items would all work.

Since you seemed to have missed class when covering diabetes here's a little help,

http://www.medicinenet.com/hypoglycemia/page3.htm

"How is hypoglycemia treated?

The acute management of hypoglycemia involves the rapid delivery of a source of easily absorbed sugar. Regular soda, juice, lifesavers, table sugar, and the like are good options. In general, 15 grams of glucose is the dose that is given, followed by an assessment of symptoms and a blood glucose check if possible. If after 10 minutes there is no improvement, another 10-15 grams should be given. This can be repeated up to three times. At that point, the patient should be considered as not responding to the therapy and an ambulance should be called.

The equivalency of 10-15 grams of glucose (approximate servings) are:

Four lifesavers 4 teaspoons of sugar 1/2 can of regular soda or juice"

The rules that the TSA has are available to every passenger from the moment they begin their travel experience. From the site one books their flight on, from the travel agent, and from the moment they enter the airport, those rules are available.

Earlier in the same post, you said:

Medical liquids are allowed. Pepsi is not a medical liquid. Scotch is not a medical liquid. The list of what is and is not a medical liquid is as long as the list of possible liquids. Far too long for the TSA to list, which is why they do not try.

So, the rules as to what constitutes a "medical liquid" are, by your own admission, not available to any passenger. This contradicts your previous statement.

We can intentionally misunderstand (big words, oops, sorry) each other all week long, but its not going to change the fact that some of the claims that something is a medical necessity are untruthful.

Why should it matter? My understanding of your SOP is that, if a passenger claims that a large container of liquid is needed for medical reasons, the TSO is supposed to separately screen the item (sorry, I don't know the name of the screening device) to ensure its safety. That separate screening may, of course, take extra time. But once that separate screening is completed, and the item is judged to be safe, who cares whether or not the passenger lied about the need for the item? The item is safe for travel.

And I don't see this creating huge problems. Sure, you'll get some smart-aleck who wants to bring his six-pack of Pepsi through on a fictitious medical condition. But when it takes y'all fifteen minutes to screen that six-pack, he'll quickly figure out whether or not that extra time wasted at the checkpoint is worth the money he saved. I think the problem would cure itself pretty quickly.

In the long run, wouldn't it be faster just to screen the Pepsi rather than pester the passenger about it and then, after they've convinced you, or called a supervisor, screen the Pepsi anyways?

One more thing. The rules that the TSA has are available to every passenger from the moment they begin their travel experience...........Would you please post the rules that list all acceptable medically necessary liquids.

Since all of these rules are available it should be a simple thing to do!

TSO Ron said in a demeaning way...Hmmm, I’m sorry that I overestimated your ability to understand the concepts I am attempting to communicate. Let me see if I can clarify things for you. I’ll try to avoid using big words.

Medical liquids are allowed. Pepsi is not a medical liquid. Scotch is not a medical liquid. The list of what is and is not a medical liquid is as long as the list of possible liquids. Far to long for the TSA to list, which is why they do not try. It is also the reason they depend on the common sense of the TSO’s and STSO’s on the checkpoint. We have no vested interest in denying someone their can of Pepsi, but it is a part of the job. And you would be amazed just how far some passengers will go to get their can past the checkpoint.

Water can be considered a medical necessity, and in reality to maintain life it is, but one can also get it for free at any water fountain or bathroom in the airport. Or, if they have issues with bathrooms, they can purchase a bottle of water from a vendor inside the sterile area. Claims that the bottle of water you bring from home is a medical necessity will most likely be viewed by TSO’s as unrealistic.

We can intentionally misunderstand (big words, oops, sorry) each other all week long, but its not going to change the fact that some of the claims that something is a medical necessity are untruthful. And there is always the option, if one questions a TSO’s decision, of asking to speak with the supervisor about it. And that’s the best option for people who just don’t like the idea of someone else telling them what to do. In the end, that’s what it comes down to, we are required to tell people what to do, and some just don’t like it. Sorry, but you do have other options. Even as you walk through the metal detector, you have options. TSO’s will not force you to do anything. You may not like the options we offer, then again you have the option of turning around and walking away. Your choice.

One more thing. The rules that the TSA has are available to every passenger from the moment they begin their travel experience. From the site one books their flight on, from the travel agent, and from the moment they enter the airport, those rules are available. I have noted in my time that people tend to interpret the rules in many different ways, but rarely do they take them at face value. Passengers can all stand on what they believe are their rights, and from what I have seen here they are wrong far more often than right. Everyone, myself included, are responsible to the flying public to do our part to make security happen. As a passenger it is in your best interests to do your part, and its my job to do mine. Few people are actual experts in aircraft security, and we must all depend on those who are to make the best policy decisions possible concerning safety.

First of all you should not be saying this "big word" mess to me. It is demeaning and implies I am stupid. You represent an agency even when you are off the clock and need to be professional. I understand everything you are saying. What you don't understand is that the website states I can take liquid through if I deem it neccessary for a medical purpose. You need to understand that you are not a doctor and that you hold TSA at risk. I guess it is easier to throw away people soda they need for a diabetic attack than to take the time to do your job and clear the item. Clearing the item is more work obviously but you don't seem to want to do it. Good use of my tax dollars. I don't like the way you conduct yourself talking to the public or how you are saying you do the job.

Jim Huggins said:“So, the rules as to what constitutes a "medical liquid" are, by your own admission, not available to any passenger. This contradicts your previous statement.”

They are also not available to TSO’s Jim, which is why I stated, once again quite clearly, that a list would be “Far too long for the TSA to list, which is why they do not try.” Which is also why it’s a collaboration between the passenger and the TSO.

Jim also said:“And I don't see this creating huge problems.”

I guess it’s a good thing that you don’t spend 8 hours a day, 5 days a week, on the checkpoint. I do see the problems. Huge one’s. To test these liquids we would be required to open each and every container, test each one, and reject more than the public would like. I can tell you, a can of Pepsi is not going to pass the test. And the 50 passengers behind the passenger who wants to bring his Pepsi into the sterile area are going to be delayed significantly. That is not our purpose, and we must balance the needs of ALL the passengers, not just the one that wants to try and get around the screening requirements. But I will happily spend as much time as necessary with a passenger as needed to endure that their needs are met, and that they are as safe to fly with as the passenger in front of them or behind them.

“I think the problem would cure itself pretty quickly.”

For that one individual it would. How about for the 3 or 4 hundred behind him who also want that special time with a TSO? We would need to add an extra 3 hours to the checkpoint process for the larger airports, and at least an hour for the smaller one’s. Are you willing to dedicate that time without complaint?

At the checkpoint, who decides whether an item is a medical necessity or not?Is it the passenger or the TSO?"

...was TSORon's "collaboration" mummery. This is not a collaboration. TSARon means the TSO/TSA does the deciding on medical necessity, and the best the passenger can do is try to convince the TSA to decide otherwise.

Is there something more reputable than TSORon we can refer to? Or is some 100-deep comment on a blog-post the best the TSA can do?

"How about for the 3 or 4 hundred behind him who also want that special time with a TSO? We would need to add an extra 3 hours to the checkpoint process for the larger airports, and at least an hour for the smaller one’s. Are you willing to dedicate that time without complaint?"

Or TSA could drop the liquids ban which protects no one from anything.

Mr. Gel-pack, TSORon speaks for himself quite clearly and does not need your assistance. When I say that its a collaboration that’s what I mean.

I know what the policy says, and I know what we have to deal with on a daily basis. I also know just how hard some people will try to bypass policies and regulations, thinking that they are smarter or special in some way that everyone else is not and therefore the regulations or policies just don’t apply to them.

I am happy to entertain ANYONE’s idea of a medical liquid. That is the point where the collaboration begins, and if there is a disagreement between myself and the passenger it is far more likely that I am going to ask the supervisor than force the passenger to do so.

You can believe that or not, your choice. I know what I do and how I do it. I’m use to people misrepresenting facts to meet their own agenda.

TSORon: If what you say is true, it is the TSA that determines medical necessity, not the passenger, the passenger's doctor, nurse, pharmacist, mother, herbalist, crystal healer, or homeopath.

To "collaborate" with the TSA in the manner you describe, the passenger must share their medical information with TSA.

Maybe you mean that it is not your responsibility as a TSO, it's up to the TSA supervisor, but from at least one passenger's perspective, that sounds like you're just passing the buck.

You are TSA.

I really don't care about the internal differences of opinion between a TSO, a TSA supervisor or the TS-XYZ airport grand pooh-bah. What I do care about is how much say does the TSA have over "medical necessities".

Perhaps my question wasn't simple enough. Let me rephrase it:

"Who decides whether an item is a medical necessity or not? Is it the passenger or the TSA?"

Sorry, I just cant make it any clearer. Its a collaboration between the passenger and the TSO. Language can only go so far in trying to communicate an idea, after that its up to the individual receiving the message to try and understand. I get the feeling that no matter how I try to get the point across, you just are not going to get it. Language fails us.

Can someone clarify if there has been a recent change in the enforcement policy regarding insulin pumps? I traveled through the Cincinnati airport earlier this week and had every item in my possession searched "because you have an insulin pump." My bags were swabbed and tested; my pump and hands were wiped and tested; every legal document in my briefcase was flipped through; clothes were disheveled; the laptop was separately turned on and incorrectly closed; etc. I was told this was a recent policy change and that an in depth search was required for anyone traveling with an insulin pump and that the agent on duty did not agree with policy but had to do it.

It wasn't the end of the world but it seems like an irrational policy if that is the case.

I am experimenting with the development of battery powered cooling devices for the personal transportation of medicines. The problems I have encountered are with uninformed personnel who are unaware of the regulatory requirements of medicines and the needs of traveling patients. I can deal with practicalities, but not red tape.I agree that more training is needed for TSOs regarding the needs of citizens with diabetes.